title: Ascending aorta diameters measured by echocardiography using both leading edge-to-leading edge and inner edge-to-inner edge conventions in healthy volunteers.
abstract: OBJECTIVE
  Reference ranges of ascending aorta diameters (AAoD) for two-dimensional echocardiography (2DE) using inner edge (IE) convention are lacking, preventing the comparison of AAoD measurements by 2DE with those obtained by other imaging modalities.
  
  
  RESULTS
  We used harmonic imaging 2DE to prospectively study 218 healthy volunteers (56% women, 42 ± 15 years, 18-80 years). Measurements were performed at the level of aortic root (AoR), sinotubular junction (STJ), and proximal tubular portion (TAo, 1 cm from the STJ) using both leading edge (LE) and IE conventions at end-diastole and end-systole. Feasibility of AAoD measurements between end-diastole and end-systole was similar at AoR and STJ levels, but it was significantly different at TAo level (82 vs. 96%, respectively, P < 0.0001). Ascending aorta diameters indexed to height were larger in men than in women (P < 0.0001). After adjusting for the effect of gender, only age and body surface area (BSA) were independent predictors of AAoD at multivariable analysis. Average end-diastolic AoR, STJ, and TAo diameters measured using IE convention were similar between genders (17 ± 2, 15 ± 2, and 15 ± 2 mm/m(2), respectively). Corresponding AAoD measured using the LE convention were 18 ± 2, 16 ± 2, and 17 ± 4 mm/m(2), respectively. On average, the end-systolic AAoD measured using LE were 2 mm larger than those performed using IE or at end-diastole. Mean aortic wall thickness was 2.4 ± 0.8 mm.
  
  
  CONCLUSIONS
  End-diastolic AAoD measured using IE were significantly smaller than those obtained either using LE convention or at end-systole. Gender-specific reference values for AAoD indexed for BSA should be used to identify ascending aorta pathology.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Science, University of Padua, School of Medicine, Via Giustiniani 2, Padua 35128, Italy.
authors.forename: Denisa
authors.initials: D
authors.lastname: Muraru
authors.forename: Francesco
authors.initials: F
authors.lastname: Maffessanti
authors.forename: Gonenc
authors.initials: G
authors.lastname: Kocabay
authors.forename: Diletta
authors.initials: D
authors.lastname: Peluso
authors.forename: Lucia
authors.initials: L
authors.lastname: Dal Bianco
authors.forename: Eleonora
authors.initials: E
authors.lastname: Piasentini
authors.forename: Seena Padayattil
authors.initials: SP
authors.lastname: Jose
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.forename: Luigi P
authors.initials: LP
authors.lastname: Badano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging; D003971:Diastole; D004452:Echocardiography; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013599:Systole
keywords: Age; Aortic root; Aortic stiffness; Ascending aorta; Body size; Echocardiography; Gender; Normal limits; Reference values; Sinotubular junction; Tubular aorta